HomeMy WebLinkAboutBLD-2022-0156 - DECONSTRUCTION & DEMOLITION si ; Cityof Anacortes Invoice/Permit#: BLD-2022-0156
904 6th Street
's Applied date: 03/07/2022
Issue date: 03/08/2022
0 Anacortes, WA 98221-0547 Expire date: 03/03/2023
Job Address: 2403 R AVE Permit Type: Commercial Demolition Permit
ANACORTES WA 98221-2811 Project:
APN: P77999
P32929
Remarks: Remove concrete building pad and ashpalt parking area. Will hydro-seed afterwards.
Owner: MJB PROPERTIES LLC Contractor: GARY MERLINO CONSTRUCTION CO
Address: 9125 10TH AVE S Address: 9125 10TH AVE S
SEATTLE WA 98108-4612 SEATTLE WA 98108-4612
Phone: (206) 762-9125 Phone: (206) 762-9125
License#:
General Information: Fees:
Dwelling Units 0 State Building Code Fee Comm 25.00
Demolition permit 60.00
Total Calculated: 85.00
Deposits/Receipts: 0.00
Total Due: 85.00
The issuance or granting of this permit shall not be construed to be a permit for,or approval of, any violation of this Code or any other ordinance or order of
the City, of any state or federal law, or of any order, proclamation, guidance advice or decision of the Governor of this State.To the extent the issuance or
granting of this permit is interpreted to allow construction activity during any period of time when such construction is prohibited or restricted by any state or
federal law, or order, proclamation, guidance advice or decision of the Governor of this State, this permit shall not authorize such work and shall not be
valid. The building official is authorized to prevent occupancy or use of a structure where in violation of this Code, any other City ordinances of this
jurisdiction or any other ordinance or executive order of the City, or of any state or federal law,or of any order, proclamation,guidance advice or decision of
the Governor. The building official is authorized to suspend or revoke this permit if it is determined to be issued in error or on the basis of incorrect,
inaccurate or incomplete information, or in violation of any City ordinance, regulation or order, state or federal law, or any order, proclamation, guidance or
decision of the Governor.This permit becomes null and void if work or construction authorized is not commenced within 180 days or if construction work is
suspended or abandoned for a period of 180 days at any time after work is commenced. I have read and e -mine: this application and know the same to
be true and correct.
SIGNATURE OF OWNER OR AUTHORIZED AGENT IS.UED
PERMIT APPLICATION FORM
PROPERTY INFORMATION
PROJECT ADDRESS(STREET,SUITE#): ASSESSOR PARCEL NUMBER:P77999
2403 R Avenue
TYPE OF STRUCTURE _
❑ Single Family ❑ Multifamily,#of Dwelling Units: ❑ Commercial/Industrial
ElP
Duplex ❑X Other Use Type: Parking area and Pad ❑ Underground Fuel Tank
STRUCTURE INFORMATION
FOR BUILDINGS:
Description of Work: Size of structure: sq.ft.
Demolish concrete pad and asphalt parking
Method of Disposal: _— Date of original construction of structure:
Excavator and Crusher NIA
HISTORIC RESOURCES INFORMATION:
Is the structure listed on the City of Anacortes Local, If identified prior to demolition,are you
State,or National register of historic places? willing to salvage from the structure
historically significant architectural features?
YES* X NO
Designation: YES X NO
*If yes,SEPA review is required prior to issuing a demolition permit.
Note: Check with the City of Anacortes Museum and/or the WA State Dept. of Archaeological and Historic
Preservation's WISSARD system to answer this question.
UTILITY&SERVICES DISCONNECTION/INTERRUPTION INFORMATION
Identify which City services you would like to disconnect/stop:
Water ❑Disconnect Detain I Storm ❑Disconnect ❑Retain
Sewer ❑Disconnect Detain Garbage ['Discontinue ❑Retain
For private utilities(gas, electricity, cable, etc.), you will need to contact the applicable companies if their
services are to be interrupted or disconnected.
FOR UNDERGROUND STORAGE TANKS:
DECOMMISSIONING TYPE:
❑Abandonment in place(Fire Dept.Approval required) E ❑ Removal
Date of pump&rinse: I Disposal Location:
Type of inert fill:
Approximate age of tank: ICC Certification#:
Deconstruction/Demolition Permit Application Submittal Checklist
Updated December 2021
Page 3 of 4
PROPERTY OWNER INFORMATION
NAME: PHONE:
MJB Properties, LLC 206-255-5153
ADDRESS(STREET,CITY,STATE,ZIP): EMAIL ADDRESS:
5050 1st Ave S, Suite 102, Seattle jblais@gmccinc.com
CONTRACTOR INFORMATION
NAME:* PHONE:
Gary Merlino Construction Co 206-762-9125
CONTRACTOR'S BUSINESS LICENSES STATE LICENSE#: CITY OF ANACORTES
*All Contractors&Subcontractors must have a i Garymcc150MW ENDORSEMENT?
valid City of Anacortes business license prior to EXPIRATION DATE: RYES NO
doing work in the City. 2/14/2023
ADDRESS(STREET,CITY,STATE,ZIP): EMAIL ADDRESS:
9125 10th Ave S, Seattle, WA 98108 jblais@gmccinc.com
FINANCING INFORMATION (Required if project valuation exceeds$5,000, per RCW 19.27.095)
Lender administering the construction financing or firm issuance a payment bond (if any)on behalf of
the prime contractor for the protection of the owner,if the bond is for an amount not less than 50%of
the total amount of the construction project(if owner is self-financing, please indicate).
Completion of this information may be deferred until permit issuance.
NAME: PHONE:
N/A
ADDRESS(STREET,CITY,STATE,ZIP):
CONTACT PERSON
Select one person the city will contact for anything related to this project:
PROPERTY OWNER DCONTRACTOR EIOTHER(LIST BELOW)
NAME: PHONE:
ADDRESS(STREET,CITY,STATE,ZIP): EMAIL ADDRESS:
SIGNATURE
I hereby declare that I am either the owner of the property listed on this application,or the owner
of this property has authorized me to be their representative to act for them. I also declare under
penalty of perjury under the laws of the State of Washington that all of the statements and answers
contained herein,and the information submitted with this application form is in all respects,true,
corrected complete to the best of knowledge and belief.
/ 3/7/2
/G4TUR DATE
Deconstruction/Demolition Permit Application Submittal Checklist
Updated December 2021
Page 4 of 4
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W 1, Storm Water Minimum Requirements #2
ENGINEERING DEPARTMENT
Waal
1891 ,44 e 904 6th Street Anacortes,WA 98221
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Official Use Only: (Information to Inspectors)
Required Storm Water Facility and other related requirements:
Sediment discharge potential is low. 85
Project Address: 2 V 03 E/51,/e. Submittal Date: /7/Z
Parcel Number: /2 77 WI Revision Number:
Permit Number: Acceptance Date(COA): 3/7/22
Reviewer: Rob F.
FRONT OF REPORT
Submittal Checklist:
o TAB 2- Drainage Analysis— Minimum Requirement#2
o APPENDIX 1 - Survey performed by a Professional Land Surveyor
o APPENDIX 2- Model Soil Management Plan for BMP T5.13
o APPENDIX 3- Determining Construction Site Sediment Damage Potential (Appendix 7)
o APPENDIX 4- Site Plan with all applicable information (Minimum Size 11x17—30 scale)
o APPENDIX 5- Documented Site Photos (North, South, East and West)
Protect Description: (What is it you are looking to do? Provide details regarding, but not limited to, Lot SF,
Ho e SF, New and Replaced Hard Surfac )
Existing Site Conditions Summary:
(Additionally, provide information on previous permits, if any, like Grade and Fill, Clear and Grade, topography,
vegetation, drainage, Critical Areas adjacent to the site and how it may affect this project if soils are disturbed,
Soils Type (Included in Sop Analysis Rep9rt), Erosion P oblem Areas, C9nstgiction Ph sing) equenc )
✓1�c4 0T YS.� �.o✓�✓ 7k1 ac l<e.1 ".ee jsk,/d l / Ve. .
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Version Date: December 19, 2018
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Devel w4<s9 1T y o { Summary:
(Addit 4, n on the site plan. Identify cut and fill areas, proposed slopes of all hard
surfac m`ours)
1891
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��FIELD 134
Site Sediment Transport Score: Total Points (HighlLow) (See Determining Construction Site
Sediment Damage Potential(Appendix 7)
Complete the Applicability Requirements—Flow Chart (Figure I-2.4.1 Attached, Figure 1-2.4.2 Attached
and Figure 1-2.5.1 Attached)
- Highlight the path and attach
DOE Stormwater Management Manual Minimum Requirements: (MR#1 to MR#5 only).
Refer to the 2012 Department of Ecology Manual, as amended in 2014 for further required information.
Version Date: December 19, 2018
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8�No. iv 35% Yes See Rede're opment Mtnenurr•
, CO4R istin Requhrernents and Flow Chart
or O FIELD n3e erage? 'Figure l-2.4.2)
L 1
No
Does the project convert 3;
�L ry■7 fig, a 1 s --ore of
vegetation to
Does the project result ir Iallo : 3rYdscaped areas, or
5.000 square feet, or No cOri..e.-, 4 5 acres or more of
greater. of new pius • ■ manse vegetation to pasture"
replaced hard surface
area?
No
Yes ill
Yes
Does the project result ir 2,OQa
V square feet, or g:reatef, of new pius
AU Minimum Requirements replaced hard surface area?
apply to the new and replaced
hard surfaces and converted Ye N.
vegetation areas.
r
:.:Ass the project have land
Minirrurnm Requirements #1 stunting activities of 7.000
through #5 apply to the new square feet or greater?
and replaced hard surfaces ��
and the land disturbed. No
■
Minimum Requirement#2
applies.
(111 Figure l- _ . I
Flow Chart for Determining Requirements for
New Development
DEPARTMENT OF Re4iseiJone2ulf.
ECOLOGY Please e'1?;�.. w.i- ec)' i'd.g0►.ccipyrigr!'Iry for wpyrirt^1once Including penni66trit,
i131e 0` Wasningt0!l trllt3tloF orIla IIt] aid aIs a1'i'er
version Date: uecemoer -iv, zu-i is
TAB 2 (MINIMUM REQUIREMENT#21
• 1-2 R• con co-- "equirement#2—Construction Stormwater Pollution Prevention Plan (SWPP)
• y �A 'equired to complete Minimum Requirement 2.
Elements of the SWPP (See document below, complete and attach)
m able 4.1.1, Table 4.2.1 and Table
7111111ac., ?ring Calculations as an attachment for Sediment Ponds\Traps, Diversions,
1891
`QCOR� °� Runoff/Stormwater Detention Calculations.
�' FIELDSe,(
134
Version Date: December 19, 2018
Table 4.1.1 Source Control BMP's by SWPPP Element
i Element 01 Element#2 Element#5 Element#6 Element#9 Element 011 Element 012 Element#13
BMP ! Preserve Establish Stabilize Protect Control Maintain Manage the Protect Low
OgCOD�CO VegetationlMark Construction Sons Slopes Pollutants BM Ps Project Impact
�4c 1 r Y O kA� C learina Lug Access DevelopmentBMPC101 02 ZY� n ✓
BMP C102 +Ana ✓ ✓
BMPC103 �4
Fence COR66*
�wO� ✓ �/
BMPC105 TOpIELptrzse ✓
Entrance l um
BMP C106: Wheel Wash ✓
BMP C107: Construction Road!Parking ✓
Area Stabilization
BMP C120:Temporary and Permanent ✓ ✓
Seeding
BMP C121: Mulching ✓ ✓
I -
BMP C122: Nets and Blankets ✓ ✓
BMP C123: Plastic Covering ✓
BMP C124: Sodding ✓
BMP C125: Topsoiling/Composting ✓
BMP C126: Polyacrylarride for Soil Erosion ✓
Protection
BMP C130: Surface Roughening ✓ ✓
BMP C131: Gradient Terraces ✓ ✓
BMP C140: Dust Control ✓
BMP C150: Materials On Hand ✓ ✓
BMP C151: Concrete Handling ✓
•
BMP C152: Sawcutting and Surfacing ✓
Pollution Prevention
BMP C153: Material Deivery,Storage and ✓
Containment
BMP C154: Concrete Washout Area ✓
BMP C160: Certified Erosion and ✓ ✓
Sediment Control Lead
BMP C162:Scheduling ✓
Version Date: December 19, 2018
Table 4.2.1 Runoff Conveyance and Treatment BMP's by SWPPP Element
low conEc0 E' anaral , 'F.- ntatt sbnlaniry8 Bennets�& Hes��11dN7 kbititK#4t3 tDt�ntl±r13
I
449 T Y 44e Col Frq arr.tsll Netact P�reet„�r tflal�iltes Control Cereal De- Pra:ca Low
w 1 O ?, r,a , Channots Impact
�� 2 s law Pi t- Slopes Drain 1nlct� l+»kar0aar tpBai Hnp
-1 !_Cc-I-rah -_ and Dunets 1 3etrelowtent
: :I.c5 � aura ✓ l ✓
— 9,� 891 �t - - - `---
._____. (>TO FIELD 1130, - — I-- — -
?<'C2az:One erei Lining V'
H- ,
-34lP C21M.! Ptpe Slope Dr-+Ps V
,....10 C208: Suamsddace Matra
— J — --- _.. r.a
EMS'( : Le et%net&r i
HMP C2O7: Check Darns ✓ ,( ✓
!BMr'CVO: roattgratar Silt d dl}sra rtmt ✓ ✓'
1—neutered Check Cm I
i_MP C200: Outlet Prebeclon I V
BMP[ : Storm Drier Inlet nrolocit an 1 ✓
BMW c2 1: Brush Barrier I V
•
BMPC7.12 Cray t il6br BArrfl ! * ,
ff
11-3MW 4e' : Set Fettle ✓ ►r
BMPC2 I Wgole, i ear•- 1 J
y
BMIP Cn. :Wethts Y"
9 w ,
lomr C2&Vegfrafire Filtration •
d'
�MI I'C24 Sediment Trap 1 I V I —
BMPC241:Terrreorsry4-r 4,'pent Pe..td I f— _
t he field 7 1A:rlraaelB®rt Sloevrue a'er ____- — —
Ch rle>rf Tria1�rerrt
8MP C251:Construction Stommwttri ✓
r MP C2Fia High nH Mrutreai•.stlen Wog f
8MP CM;pat Control far Nigh pH Ws%r V
Version Date: December 19, 2018
FORconEco 13 Elements of SWPPP
1T Y O 4A (Construction Stormwater Pollution Prevention Plan)
Please m;how that each element has been read and understood. Provide details where
applics Waal pects are unnecessary or exempt, clearly justify. Details of the 13 Elements and the
correla + 1891 wk Above from the 2014 Stormwater Management Manual for Western Washington
(SWMI `QCO 9 'ided on the City of Anacortes website, under Planning, Community, & Economic
Develc O FIELD 134 as well as under Stormwater on the Engineering Division of Public Work's page.
Owner Name: � 2Lc.
Site Address: -2. yG ive
Prepared By: T;I27 /�1
The Stormwater checklist or building permit determined that:
❑ The 13 elements must be addressed 0 These elements must be addressed
for construction activity adding under for construction activity adding 2,000
2,000 sq. ft. of hard surface area. sq. ft. or more of hard surface area.
This means that an attached narrative
and site plan are required with this
document.
Under each element. explain the best management practices 1BMPs) used or justify reasoning for
those that will not be used. If needed. please attach a narrative to further explain plans or Lustification.
ELEMENT 1: Preserve Vegetation/Mark Clearing Limits
❑ Before beginning land disturbing activities, including clearing and grading, clearly mark all clearing
limits, sensitive areas and their buffers, and trees that are to be preserved within the construction area.
❑ Retain the duff layer, native top soil, and natural vegetation in an undisturbed state to the maximum
degree practical.
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Version Date: December 19, 2018
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ELEME ,(4,9 1T Y �Ar istruction Access
Cl/ m chicle access and exit to one route, if possible.
7.WAX nts with a pad of quarry spalls, crushed rock, or other equivalent BMPs, to minimize
❑ 4 1891 ,St,
Co (' or tire baths on site, if the stabilized construction entrance is not effective in
4uFret.o�se sediment onto roads.
If sediment is tracked off site, clean the affected roadway thoroughly at the end of each day, or more
frequently as necessary (ex: wet weather). Remove sediment from roads by shoveling, sweeping, or
pick up and transport the sediment to a controlled sediment disposal area.
❑ Conduct street washing only after sediment is removed in accordance with the above bullet.
❑ Control street wash wastewater by pumping back on site or otherwise preventing it from discharging
into systems tributary to waters of the State.
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ELEMENT 3: Control Flow Rates
❑ Protect properties and waterways downstream of development sites from erosion and the associated
discharge of turbid waters due to increases in the velocity and peak volumetric flow rate of stormwater
runoff from the project site.
❑ Where necessary to comply with the bullet above, construct stormwater retention or detention facilities
as one of the first steps in grading. Assure that detention facilities function properly before constructing
site improvement (e.g. impervious surfaces).
❑ If permanent infiltration ponds are used for flow control during construction, protect these facilities from
siltation during the construction phase.
ce�r
Version Date: December 19, 2018
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0AlliELEMI d � m ent Controls
[� 4, °3 o� maintain effective erosion controls and sediment controls to minimize the discharge
�7OFIFID114 control BMPs (sediment ponds, traps, filters, etc.) as one of the first steps in
grading. These BMPs shall be functional before other land disturbing activities take place.
71 Minimize sediment discharges from the site. The design, installation and maintenance of erosion and
sediment controls must address factors such as the amount, frequency, intensity and duration of
precipitation, the nature of resulting stormwater runoff, and soil characteristics, including the range of
soil particle sizes expected to be present on the site.
❑ Direct stormwater runoff from disturbed areas through a sediment pond or other appropriate sediment
removal BMP, before the runoff leaves a construction site or before discharge to an infiltration facility.
Runoff from fully stabilized areas may be discharged without a sediment removal BMP, but must meet
the flow control performance standard in Element#3, bullet#1.
❑ Locate BMPs intended to trap sediment on-site in a manner to avoid interference with the movement of
juvenile salmonids attempting to enter off-channel areas or drainages.
❑ Provide and maintain natural buffers around surface waters, direct stormwater to vegetated areas to
increase sediment removal, and maximize stormwater infiltration.
❑ Where feasible, design outlet structures that withdraw impounded stormwater from the surface to avoid
discharging sedi�me�nt that is still suspende�j��,, lower in the water colu n.
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ELEMENT 5: Stabilize Soils
• Stabilize exposed and unworked soils by application of effective BMPs that prevent erosion. Applicable
BMPs include, but are not limited to: temporary and permanent seeding, sodding, mulching, plastic
covering, erosion control fabrics and matting, soil application of polyacrylamide (PAM), the early
application of gravel base early on areas to be paved, and dust control.
❑ Control stormwater volume and velocity within the site to minimize soil erosion.
❑ Control stormwater discharges, including both peak flow rates and total stormwater volume,to minimize
erosion at outlets and to minimize downstream channel and stream bank erosion.
{/ Soils must not remain exposed and unworked for more than the time periods set forth below to prevent
erosion.
o During the dry season (May 1 —Sept 30): 7 days
o During the wet season (Oct 1 —Apr 30): 2 days
Stabilize soils at the end of the shift before a holiday or weekend if needed based on the weather
forecast.
❑ Stabilize soil stockpiles from erosion, protect with sediment trapping measures, and where possible, be
Version Date: December 19, 2018
located away from storm drain inlets, waterways, and drainage channels.
❑ Minimize the amount of soil exposed during construction activity.
❑ Mir oo�CobEco lance of steep slopes.
❑ w�� 1T y A{ lotion and, unless infeasible, preserve topsoil.
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ELEMENT 6: Protect Slopes
❑ Design and construct cut-and-fill slopes in a manner to minimize erosion. Applicable practices include,
but are not limited to, reducing continuous length of slope with terracing and diversions, reducing slope
steepness, and roughening slope surfaces (Ex: track walking).
❑ Divert off-site stormwater (run-on) or ground water away from slopes and disturbed areas with
interceptor dikes, pipes, and/or swales. Off-site stormwater should be managed separately from
stormwater generated on the site.
❑ At the top of slopes, collect drainage in pipe slop drains or protected channels to prevent erosion.
o *Temporary pipe slope drains must handle the peak volumetric flow rate calculated using a 10-
minute time step from a Type 1A, 10-year, 24-hour frequency storm for the developed condition.
Alternatively, the 10-year, 1-hour flow rate predicted/indicated by an approved continuous runoff
model, increased by a factor of 1.6, may be used. The hydrologic analysis must use the existing
land cover condition for predicting flow rates from tributary areas outside the project limits. For
tributary areas on the project site, the analysis must use the temporary or permanent project
land cover condition, whichever will produce the highest flow rates. If using the Western
Washington Hydrology Model (WWHM) to predict flows, bare soil areas should be modeled as
"landscaped" area.
o Where 15-minute time steps are available in an approved continuous runoff model, they may be
used directly without a correction factor.
❑ Place excavated material on the uphill side of trenches, consistent with safety and space
considerations.
❑ Place check dams at regular intervals within constructed channels that are cut down a slope.
❑ Consider soil types and its potential for erosion.
❑ Stabilize soils on slopes, as specified in Element 5.
❑ BMP combinations are the most effective method of protecting slopes with disturbed soils. Ex: Use both
mulching and straw erosion control blankets.
Version Date: December 19, 2018
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ELEMENT 7: Protect Drain Inlets
V Protect all storm drain inlets made operable during construction so that stormwater runoff does not
enter the conveyance system without first being filtered or treated to remove sediment.
V Clean or remove and replace inlet protection devices when sediment has filled one-third of the available
storage (unless a different standard is specified by the product manufacturer).
Where possible, protect all existing storm drain inlets so that stormwater runoff does not enter the
—/conveyance system without first being filtered or treated to remove sediment.
�y Keep all approach roads clean. Do not allow sediment and street wash water to enter storm drains
without prior and adequate treatment unless treatment is provided before the storm drain discharges to
,/waters of the State.
Inlets should be inspected weekly at a minimum and daily during storm events.
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ELEMENT 8: Stabilize Channels and Outlets
❑ Design, construct, and stabilize all on-site conveyance channels to prevent erosion from the following
expected peak flows:
o *Channels must handle same peak volumetric flow rate as temporary pipe slope drains listed in
Element 6, above.
❑ Provide stabilization, including armoring material, adequate to prevent erosion of outlets, adjacent
streambanks, slopes, and downstream reaches at the outlets of all conveyance systems.
❑ The best method for stabilizing channels is to completely line the channel with a blanket product first,
then add check dams as necessary to function as an anchor and to slow the flow of water
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Version Date: December 19, 2018
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ELEMENT 9: Control Pollutants
❑ Design, install, implement, and maintain effective pollution prevention measures to minimize the
discharge of pollutants.
❑ Handle and dispose of all pollutants, including waste materials and demolition debris that occur on-site
in a manner that does not cause contamination of stormwater.
❑ Provide cover, containment, and protection from vandalism for all chemicals, liquid products, petroleum
products, and other materials that have the potential to pose a threat to human health or the
environment. On-site fueling tanks must include secondary containment. Secondary containment
means placing tanks or containers within an impervious structure capable of containing 110% of the
volume contained in the largest tank within the containment structure. Double-walled tanks do not
require additional secondary containment.
Conduct maintenance, fueling, and repair of heavy equipment and vehicles using spill prevention and
control measures. Clean contaminated surfaces immediately following any spill incident.
❑ Discharge wheel wash or tire bath wastewater to a separate on-site treatment system that prevents
discharge to surface water, such as closed-loop recirculation or upland land application, or to the
sanitary sewer, with local sewer district approval. Wheel wash or tire bath wastewater should not
include wastewater from concrete washout areas.
❑ Apply fertilizers and pesticides in a manner and at application rates that will not result in loss of
chemical to stormwater runoff. Follow manufacturers' label requirements for application rates and
procedures.
❑ Use BMPs to prevent contamination of stormwater runoff by pH-modifying sources. The sources for this
contamination include, but are not limited to: bulk cement, cement kiln dust, fly ash, new concrete
washing and curing waters, waste streams generated from concrete grinding and sawing, exposed
aggregate processes, dewatering concrete vaults, concrete pumping, and mixer washout waters. Adjust
the pH of stormwater if necessary to prevent violations of the water quality standards.
❑ Assure that washout of concrete trucks is performed off-site or in designated concrete washout areas
only. Do not wash out concrete trucks onto the ground, or into storm drains, open ditches, streets, or
streams. Do not dump excess concrete on site, except in designated concrete washout areas. Concrete
spillage or concrete discharge to surface waters of the State is prohibited. Do not use upland land
applications for discharging wastewater from concrete washout areas.
❑ Obtain written approval from Ecology and provide to the City before using chemical treatment other
than CO2 or dry ice to adjust pH.
❑ Woody debris may be chopped and spread on site.
❑ Conduct oil changes, hydraulic system drain down, solvent and de-greasing cleaning operations, fuel
tank drain down and removal, and other activities which may result in discharge or spillage of pollutants
to the ground or into stormwater runoff using spill prevention measures, such as drip pans.
0' Clean contaminated surfaces immediately following any discharge or spill incident. Emergency repairs
may be performed on-site using temporary plastic� placed beneath and, if raining, over the vehicle.
3�i l/ R,T ti/W fee, �y &rl�17a/L. f''�UGr�e ce; �/�4� s . .
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ELEMENT 10: Control De-Watering
❑ Discharge foundation, vault, and trench dewatering water, which have characteristics similar to
stormwater runoff at the site, into a controlled conveyance system before discharge to a sediment trap
or sediment pond.
❑ Discharge clean, non-turbid de-watering water, such as well-point ground water, to systems tributary to,
or directly into surface waters of the State, as specified in Element 8, provided the de-watering flow
does not cause erosion or flooding of receiving waters or interfere with the operation of the system. Do
not route clean dewatering water through stormwater sediment ponds. Note that"surface waters of the
State" may exist on a construction site as well as off site; for example, a creek running through a site.
LI Handle highly turbid or contaminated dewatering water separately from stormwater.
❑ Other treatment or disposal options may include:
1. Infiltration
2. Transport off-site in a vehicle, such as a vacuum flush truck, for legal disposal in a manner that
does not pollute state waters.
3. Ecology-approved on-site chemical treatment or other suitable treatment technologies.
4. Sanitary or combined sewer discharge with local sewer district approval, if there is no other
option.
5. Use of a sedimentation bag with outfall to a ditch or swale for small volumes of localized
dewatering.
❑ Construction equipment operation, clamshell digging, concrete tremie pour, or work inside a cofferdam
can create highly turbid or contaminated dewatering water.
❑ Discharging sediment-laden (muddy) water into waters of the State likely constitutes a violation of water
quality standards for turbidity. The easiest way to avoid discharging muddy water is through infiltration
and preserving vegetation.
/1/4 Ple- !4_ .ufr.. �/ CCya/7 7747'(/
ELEMENT 11: Maintain BMPs
C/ Maintain and repair all temporary and permanent erosion and sediment control BMPs as needed to
assure continued performance of their intended function in accordance with BMP specifications.
IV Remove all temporary erosion and sediment control BMPs within 30 days after achieving final site
stabilization or after the temporary BMPs are no longer needed. Some temporary erosion and sediment
Version Date: December 19, 2018
control BMPs are bio-degradable and designed to remain in place following construction such as
compost socks.
❑ Pro FoRconico' _ .3 all BMPs installed for the permanent control of stormwater from sediment and
° 1T Y O 4A{ Ds that are to remain in place following completion of construction shall be
% �� d in full operating conditions. If sediment enters the BMPs during construction, it
Cr''id the facility shall be returned to the conditions specified in the construction
NOM
u,/ 74, 1891 �w�o� trapped sediment on site. Permanently stabilize disturbed soil resulting from
`QC OR vegeta ion.
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ELEMENT 12: Manage the Project— Projects subject to Minimum Requirements 1-9 must have a Certified
Erosion and Sediment Control Lead (CESCL)for site inspections. Projects subject to Minimum Requirements
1-5 do not require the inspector to be certified. By the initiation of construction, the SWPPP must identify the
CESCL or inspector, who shall be present on-site or on-call at all times.
❑ Phase development projects to the maximum degree practicable and take into account seasonal work
limits to prevent soil erosion and prevent transporting sediment from the site during construction.
V Inspection and monitoring — Inspect, maintain, and repair all BMPs as needed to assure continued
performance of their intended function.
❑ Maintain, update, and implement the SWPPP.
❑ Clearing and grading activities for developments shall be permitted only if conducted using an approved
site development plan (e.g., subdivision approval).
❑ From Oct 1 through Apr 30, clearing, grading, and other soil disturbing activities is permitted only if
shown that the site operator will prevent silt-laden runoff from leaving the site through a combination of
the following:
1. Site conditions including existing vegetative coverage, slope, soil type, and proximity to
receiving waters.
2. Limit activities and the extent of disturbed areas.
3. Proposed erosion and sediment control measures.
Weather conditions can influence the seasonal limitation on site disturbance. The City of Anacortes has
the authority to take enforcement action per AMC 19.76 Stormwater.
0 The following activities are exempt from the seasonal clearing and grading limitations:
1. Routine maintenance and necessary repair of erosion and sediment control BMPs;
2. Routine maintenance of public facilities or existing utility structures that do not expose the soil or
result in the removal of the vegetative cover to soil
3. Activities where there is 100% infiltration of surface water runoff within the site in approved and
installed erosion and sediment control facilities.
Version Date: December 19, 2018
577c- 4/,1/ a 4 /60/ i1S _CZ,-FYI 'r
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ELEMENT 13: Protect Low Impact Development BMPS
❑ If implementing any bioretention facilities or rain gardens, refer to the applicable BMP sections of the
Manual for requirements.
•
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) tinatfe Date
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PROJECT INFORMATION "Model Soil Management Plan for BMP T5.13" age# of pages
Complete all information on page 1;only site address and permit number on additional pages.
Site Address/Lot No.:
Permit Type: Permit Number:
Permit Holder: Phone:
Mailing Address:
Contact Person: Phone:
Plan Prepared By:
ATTACHMENTS REQUIRED(Check olf required items that are attached to this plan)
_Site Plan showing,to scale: _Areas of undisturbed native vegetation(no amendment required)
New planting beds and turf areas(amendment required)
Type of soil improvement proposed for each area _
Soil test results(required if proposing custom amendment rates)
Product test results for proposed amendments
AREA# (should match Area#on Site Plan)
PLANTING TYPE _Turf _Undisturbed native vegetation
Planting Beds _Other:
SQUARE FOOTAGE OF THIS AREA: square feet
SCARIFICATION inches(depth)of scarification needed to achieve finished total 12"loosened depth.
Subsoil will be scarified
PRE-APPROVED inches of compost or imported topsoil applied
AMENDMENT METHOD: X 3.1 (conversion factor, inches to cubic yards) PRODUCT:
Topsoil import =cu.yards per 1,000 sq.ft.
Amend with compost X ,000s sq.ft.in this area
Stockpile and amend =cubic yards of amendment —>—*—*—p—* QUANTITY: CU.YDS.
( cu.yds.stockpiled) (needed to cover this area to designated depth) -
CUSTOM AMENDMENT Attach test results and calculations.
Topsoil import inches organic matter or topsoil import PRODUCT:
Topsoil&compost lift X 3_1
Amend =cu.yards/1,000 sq.ft.
Stockpile and amend X ,000s sq.ft.in this area
( cu.yds.stockpiled) =cubic yards of amendment -->—>—>—>-> QUANTITY: CU.YDS.
MULCH _,000 sq.ft. — PRODUCT:
X 6.2 (conversion, to give 2 inch mulch depth)
=cubic yards of mulch ——4—*—>—>— QUANTITY:_ CU.YDS.
TOTAL AMENDMENT/TOPSOIL/MULCH FOR ALL AREAS(complete on page 1 only, totaling all areas/pages in this Plan)
I ❑ Product#1; ❑Quantity: cu.yds.
Version Date: December 19, 2018
❑ Test Results:_%organic matter C:N ratio<25:1 (except mulch,or<35:1 for native plants) "stable"(yes/no)
❑ Product#2: ❑Quantity: cu.yds.
❑ Test R^-••'-� °'^-~�^nic matter C:N ratio<25:1 (except mulch,or<35:1 for native plants) "stable"(yes/no)
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❑ Pi �4p 44 ❑Quantity: cu.yds.
❑ T G1T Y O, �� nic matter C:N ratio<25:1 (except mulch,or<35:1 for native plants) "stable"(yes/no)
m
Date: NM 1 Approved: Revisions Required:
v,�4, 1891 ,�
Date: �,� �1C0jL`S 0 Approved: Revisions Required:
� 0FIELD Sep
APPENDIX 1 —Survey performed by a Professional Land Surveyor
Version Date: December 19, 2018
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APPENDIX 2— Model Soil Management Plan for BMP T5.1:
Note: Document is provided under Minimum Requirement 5 in this document
Version Date: December 19, 2018
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APPENDIX 3— Determining Construction Site Sediment Damage Potential (Appendix 7—NPDES Phase
II Permit)
Note: See attached
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Western Washington Phase II Stormwater Permit
APPENDIX 7 — Determining Construction Site
Sediment Damage Potential
The following rating system allows objective evaluation of a particular development site's potential to
discharge sediment. Permittees may use the rating system below or develop alternative process
designed to identify site-specific features which indicate that the site must be inspected prior to clearing
and construction. Any alternative evaluation process must be documented and provide for equivalent
environmental review.
Step one is to determine if there is a sediment/erosion sensitive feature downstream of the development
site. If there is such a site downstream complete step two, assessment of hydraulic nearness. If there is
a sediment/erosion sensitive feature and it is hydraulically near the site then go to step three to
determine the construction site sediment transport potential.
ii. STEP 1 —Sediment/Erosion Sensitive Feature Identification
Sediment/erosion sensitive features are areas subject to significant degradation due to the effect of
sediment deposition or erosion. Special protection must be provided to protect them.
Sediment/erosion sensitive features include but are not limited to:
i. Salmonid bearing fresh water streams and their tributaries or freshwater streams that
would be Salmonid bearing if not for anthropogenic barriers;
ii. Lakes;
iii. Category I, II, and Ill wetlands;
iv. Marine near-shore habitat;
v. Sites containing contaminated soils where erosion could cause dispersal of
contaminants; and
vi. Steep slopes (25% or greater) associated with one of the above features.
Identify any sediment/erosion sensitive features, and proceed to step two. If there are none the assessment
is complete.
iii. STEP 2—Hydraulic Nearness Assessment
Version Date: December 19, 2018
Sites are hydraulically near a feature if the pollutant load and peak quantity of runoff from the site will not
be naturally attenuated before entering the feature. The conditions that render a site hydraulically near
to a fey*•FoRcofleo 1-..*are not limited to, the following:
�,�� Y �Ar ire or a buffer to protect the feature is within 200 feet downstream of the site.
C) ,� m the site is tight-lined to the feature or flows to the feature through a channel
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August 1, 2013, Modified January 16, 2015 Appendix 7- Determining Sediment Damage
Potential Page 1 of 3
Version Date: December 19, 2018
OgCODEw4<s)) y co 41Ae ically near a feature if one of the following takes place to provide attenuation
�, �� ie site enters the feature:
st flow through a vegetated area with dense ground cover
WON through a wetland not included as a sensitive feature
1891 ' o� through a significant shallow or adverse slope, not in a conveyance
QCOR nel, between the site and the sensitive feature.
71iFretonsse� ediment/erosion sensitive features from step one that are hydraulically near
the site, and proceed to step three. If none of the sediment/erosion sensitive features are
hydraulically near the site, the assessment is complete.
vii. STEP 3—Construction Site Sediment Transport Potential
Using the worksheet below, determine the total points for each development site. Assign points
based on the most critical condition that affects 10% or more of the site.
If soil testing has been performed on site, the results should be used to determine the
predominant soil type on the site. Otherwise, soil information should be obtained from the
county soil survey to determine Hydrologic Soil Group (Table of Engineering Index Properties
for step 1.D) and Erosion Potential (Table of Water Features for step 1.E)
When using the county soil survey, the dominant soil type may be in question, particularly when
the site falls on a boundary between two soil types or when one of two soil types may be present
on a site. In this case, the soil type resulting in the most points on the rating system will be
assumed unless site soil tests indicate that another soil type dominates the site.
Use the point score from Step 3 to determine whether the development site has a high potential
for sediment transport off of the site.
Total Score Transport Rating
<100 Low
❑100 High
A high transport rating indicates a higher risk that the site will generate sediment contaminated
runoff.
CcQFORcon-Eco - Sediment Transport Potential Worksheet
w4( 1TY A{
of site (average, weighted by aerial extent.. Points 2%
891 `S-
C 15
`QOR 30
FIFI.D�se 50
B. Site Area to be cleared and/or graded:
<5,000 sq. ft
5,000 sq. ft.— 1 acre 0
>1 acres 50
C. Quantity of cut and/or fill on site:
<500 cubic yards QO
500—5,000 cubic yards 5
>5,000— 10,000 cubic yards 10
>10,000—20,000 cubic yards 25
>20,000 cubic yards 40
D. Runoff potential of predominant soils (Natural Resources Conservation Service):
Hydrologic soil group A
Hydrologic soil group B 10
Hydrologic soil group C 20
Hydrologic soil group D 40
E. Erosion Potential of predominant soils (Unified Classification System): GW,
GP, SW, SP soils 00
Dual classifications (GW-GM, GP-GM, GW-GC,
GP-GC, SW-SM, SW-SC, SP-SM, SP-SC) 10
GM, GC, SM, SC soils 20
ML, CL, MH, CH soils 40
F. Surface or Groundwater entering site identified and intercepted/:
Yes 0
No 25
G. Depth of cut or height of fill >10 feet:
Yes 25
No 0
H. Clearing and grading will occur in the wet season (October 1 —May 1): Yes 50
No 0
TOTAL POINTS 85
1 If no surface or groundwater enters site, give 0 points.
APPENDIX 4—Site Plan with all applicable information (Minimum Size 11x17 at a legible scale)
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APPENDIX 5— Documented Site Photos (Show all directions of the site, including frontage)
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